Plastic Passion by Andi Zeisler

How Plastic Surgeons and the Journalists Who Cover Them are Reshaping Our Bodiesâ€š and Our Minds

I’m slumped in the vinyl haircutting chair while my stylist disposes of my split ends. Because of the height of the chair, and because Nan is wearing what amounts to a bra and leggings, I spend most of the haircut gazing idly into her abundant, tattooed cleavage. At some point, she notices me looking and smiles, giving a nonchalant little tug to the cantilevered, lacy affair that binds her chest. “As soon as I turn 35,” she swears, “it’s lift city.”

It seems like people have started talking about having cosmetic surgery the way they used to talk about having childrenâ€šas an abstract inevitable, something that will occur at some unspecified time in the future. As a society, we’ve grown inured to the concept of cosmetic surgery and nonplussed by its presence in our daily lives. It’s played for laughs in culture both high (a New Yorker cartoon) and low (your average sitcom). It’s standard fodder for daytime talk shows; free weeklies and ads on public transportation hawk it aggressively; and the entertainment glossies make sure we know exactly what Demi Moore’s breasts are up to. Its terms have invaded the vernacularâ€šwe’re no more surprised to see a magazine with the cover line “Your Kitchen Needs a Face-Lift!” than we are to hear that Cher had another rib or three removed.

And we’re not just hearing about other people’s operations; where cosmetic surgery was once mainly the province of wealthy socialites, aging movie stars, and strippers, it’s now an equal-opportunity proposition, complete with tv commercials and low-cost financing plans hawked on the World Wide Web. The American Society of Plastic and Reconstructive Surgeons reports that, over the past five years, the rate of breast augmentation surgeries has more than tripled; liposuctions have grown by 200 percent; and liposuctions performed on men have tripled. Cosmetic surgeries in general have increased by more than half since 1992. In our society, it’s no longer nature that determines who’ll be the fittestâ€šit’s the surgeons, and the people with the money to pay their astronomical bills.

There’s plenty that’s straight-up disturbing about this kind of cosmetic Darwinism. There’s the classism and racism inherent in the body-reshaping industry, for one, and the eugenic implications of a world full of people with bodies and faces that reflect a fashion-model ideal. Surgery and the fashion/beauty industries have informed each other from the start, and this union, along with long-standing Hollywood associations, has plenty to do with why certain segments of culture are still prone to deriding cosmetic surgery as vain, shallow, and devoid of personal meaning, especially when compared to its hipper body-modification counterparts of tattooing and piercing. When a grown woman undergoes twenty-plus operations to transform herself into a giant Barbie dollâ€šas frequent talk-show guest Cindy Jackson didâ€šor compares cosmetic surgery to tuning up the carâ€šas Loni Anderson hasâ€šis it any wonder?

The evolution of cosmetic surgery into pop culture touchstone ensures that there’s now less stigma attached, but it also means that we’re seeing a lot more media coverage of it that pushes a lighthearted, even whimsical agenda. A recent issue of Vogue features “Calf Masters,” a piece that asks, “Are you ready for spring’s capri pants and pleated schoolgirl skirts? Are your legs?” and then swings right into a perky evaluation of surgical options (including calf implants and inner-knee liposuction) for optimum capri-pant effect. Not that this kind of thing is unprecedented; most women’s magazines start running their get-ready-for-summer exercise features around March, but those generally stop short of suggesting going under the knife in order to make the most of one’s bikini. The ease with which Vogue proposes a spendy operation for the sake of a fleeting trend points to the classism implicit in cosmetic Darwinism, but also embodies a shift in the m.o. of the cosmetic surgery shill. Glossy magazines, despite their overstock of wafer-thin models, have generally shouldered the mantle of responsibility when it comes to surgery, urging their readers to think carefully and at length about what is a big, expensive, and possibly dangerous undertaking. An article like “Calf Masters,” in repositioning surgery as breezy and blatantly fashion-powered, suggests that corners of the media are ready to unload the responsibility part and focus on the gee-whiz thrill of surgical advances.

On the other hand, with this casually but determinedly pro-knife attitude prevailing, certain culture machines are feeling their share of guilt for helping to advance a lipo-for-everyone consciousness. This became apparent on a recent episode of Beverly Hills, 90210, which addressed, within one hour, a whole host of issues with an eye toward dramatically presenting The Media Enslavement of Women. Pornography, sex toys, the body disorder known as cutting, dieting, sizeism, and cosmetic surgery were trotted out one after another in neat five-minute segments. Cosmetic surgery’s moment in the 90210 spotlight went a little something like this:

Kelly’s Mom: “I’m going to have a face-lift next week, and I won’t be able to chew for a while. I’ll be drinking lots of smoothies.” Kelly: “You’re kidding me!” “Honey, this is Beverly Hills. We never joke about plastic surgery.” “Mom, you look great! What are you thinking?” “Forty percent off for people in their forties got me startedÃ¤and the thought of losing the bags under my eyes sealed the deal.”

The talk then immediately shifted, addressing another bite-size issue, and those of us who hadn’t run screaming from the room were left to ponder this dialogue. On its own, the skimpy exchange might have just been filler, but situated within the rest of the topic-heavy hour, it became a firmly anti-surgery Message. This is a marvel of hypocrisy for a television show that sometimes seems extant solely to display Tori Spelling’s baseball-in-a-sockbreast implants. Since its inception, 90210′s blond-’n’-tan glossiness and the ever-morphing bodies of its female stars have helped perpetuate the idea that you’re never too young to start remodeling your flesh. (Allure magazine recently featured Candy Spellingâ€šwife of producer Aaron, mother of sock-chested Toriâ€šannouncing that she’s “a great believer in plastic surgery.” Shocking, we never would have guessedÃ¤) Nevertheless, the show’s hastily assembled cosmetic surgery=oppression moral posturing indicates that someone within its chain of command is concerned that perhaps all these years of televised focus on bodily perfection might somehow poison the minds of impressionable viewers, and it’s high time to start backpedaling. Living Fit, in the meantime, published an article that comprised the results of a survey in which male and female baby boomers were questioned about their attitudes on cosmetic surgery. The piece, titled “The Unkindest Cut,” aims to counter the media buzz on a “cosmetic surgery boom” with an emphatic statement that people are really much happier with themselves than we’d all like to think. The main evidence of this, however, isn’t that fewer people are choosing surgery, but that more people are having procedures, or what Living Fit refers to as “lunch-hour surgery: noninvasive or minimally invasive wrinkle-fighting procedures like laser skin resurfacing; Retin-A treatment; chemical peels; and Botox, collagen, Fibril and fat injections.” The intent seems to be to draw a line in the sand over what is and isn’t cosmetic surgery, and the piece congratulates itself heartily for doing so, with a neat conclusion that the alleged boom is “really more of a boomlet.”

Who are they kidding? The distinction between boom and boomlet isn’t the crucial point. It’s as though Living Fit thinks the fact that some folks are choosing to temporarily paralyze their faces with botulism toxin rather than go full-on with the face-lift is somehow indicative of a healthy, propaganda-free, anti-surgery attitude. But the only thing it’s indicative of is that vanity is still a huge issue when it comes to how people conceptualize/rationalize their body modification (e.g., “If it doesn’t involve actual cutting, maybe it’s ok”). Increasingly sophisticated technology has made cosmetic surgery less taxing, less time-consuming, and less embarrassing for the people who choose it, but in the process it’s fueling the development of some bizarre moral hierarchy of cosmetic procedures.

For feminists, this approach to cosmetic surgery offers a special stumbling block. Given that the bulk of cosmetic Darwinism involves making women feel insecure and competitive, there would seem to be a responsibility to denounce an article like “Calf Masters,” and surgery itself, as about as empowering and forward-thinking as corsets and footbinding. Yet cheery testimony of how the face-lift or the breast implants were “for me,” and, by extension, for feminist self-realization, permeates many a first-person chronicle of surgery. Furthermore, feminism these days is about defining our own terms, being able to adapt former definitions and shift them around to suit us. This is why we not only no longer have to shun lipstick, but can actually turn the act of wearing it into a feminist statement (although, to the casual observer, the power and righteousness of this statement might go unnoticed and we might simply appear to be women in lipstick). And when some uninformed fool tries to protest that “real” feminists don’t shave their legs or stand drooling at the LancÃ™me counter, we’re damn skippy going to stand up and loudly defend our right to be as girly as we please. So why are we so defensive when it comes to cosmetic surgery?

A partial explanation is that it is, after all, surgery. Taking three minutes to apply lipstick or eye shadow is a hell of a lot different from allowing a total stranger to cut open and rearrange the skin over your face, to suck a pint of fat from your body through a tube, to insinuate bags full of salt water into your chest. The attendant risks of surgery, the pain, the time it takes to recover, and the secrecy and guilt that often accompany the undertaking all add up.

But there’s more. Elizabeth Haiken, author of Venus Envy: A History of Cosmetic Surgery, argues that cosmetic surgery has from the start been framed as part and parcel of the American entitlement to constant self-improvement. But she also points out that, when it comes to current attitudes about surgery, the practice of dismissing the cultural context and rationalizing it as individual betterment “flattens the terrain of power relations.” In other words, we may be helping ourselves, but we’re not helping ourselves. We can talk about doing it for us until our high-end lipstick flakes off, but we should also keep in mind that we probably wouldn’t even be thinking about what life would be like with a new nose or perkier breasts or shapelier inner thighs if it weren’t for a long-standing cultural ideal that rewards those who adhere to itâ€šwith power that often doesn’t speak its name but is instantly recognizable to those who don’t have it.

Sure, maybe pop cultural forces can help undo the history of body hatred foisted upon women and girlsâ€šbut only if they avoid the kind of apologetic waffling and hypocritical pap peddled by 90210 and Living Fit. The blanket statement of “Cosmetic surgery! Bad for women!” ignores important subtleties. It’s hard to condemn someone whose insecurity about having small breasts poisons the rest of her life; for her, that amounts to a feminist issue. The larger theoretical frameworkâ€šthe idea that by submitting to the knife, women capitulate to a pernicious social code that ranks female worth by adherence to the beauty ideal, etc.â€šis very real, but it isn’t going to help someone whose day-to-day life has already been damaged by this code and just wants to get implants and get on with living. It’s as hazardous to applaud only those who don’t choose surgery as being worthy of feminist approbation as it is to roundly denigrate those who do.

I was 17 when I first saw the results of a real live face-lift. “My mother really doesn’t want anyone to see her,” said a friend cautiously when I expressed curiosity at what someone three days out from under the scalpel might look like. And, frankly, I was sorry I asked. The formerly gorgeous face of her mother was as bright red and raw as a cut of uncooked beef, the eyes swollen to slashes in a face that appeared to be sliding off under theweight of medicated ointment. “Just imagine sitting across from that at the dinner table every night,” remarked my friend. “But, you know, if it makes her happyÃ¤” I couldn’t help feeling that both my friend and her mother had been duped. Happy? What was there to be happy about in a face-lift? It seemed impossible that it could be a choice when the idea was generated not by my friend’s mom but by a host of external forcesâ€šby the fashion glossies, by the men her age who only dated women in their 20s, by the cityaround her that valued dewy-skinned youth above all else. The personal choice, in that context, meant nothing. But what seemed to me at 17 to be a submission to a beauty ideal birthed on Madison Avenue has become a lot more. Women are increasingly visible in forming culture and instituting change, but when we look at the rising cosmetic surgery statistics, the idea that there might be some sort of connection between the two is impossible to ignore. With visibility comes scrutiny, and we’ve all seen how the annals of pop culture treat the visible woman whose livelihood has nothing to do with her looks. It’s the Hillary’s Hair syndromeâ€šshow the world a potent woman and all they want to do is talk about how big her ass is or whether she should go blonder. One of the idealistic myths of feminism is that an increase in female power will somehow effect a momentous change wherein the multibillion-dollar fashion/beauty cabal will magically loosen its grip on women everywhere. It’s the result of years of push-pull struggle within the constraints of our image-obsessed culture, but it isn’t necessarily logical.

So even if nobody’s strapping women to gurneys and rolling them down halls lined with scalpel-wielding men in green, cosmetic Darwinism is definitely greasing the wheels. The terrain of power relations, to cop Haiken’s phrase, is only getting flatter with time. Whether we feel like we need to look a certain way to make up for cultural power that we don’t have, or whether looks are still a major means by which we achieve powerâ€šor whether we refuse to give credence to either of these ideasâ€šwhat we’re born with is still going to be weighed against what surgery can give us: weighed by glossy magazines, by television shows, by friends, by strangers. Individual self-actualization isn’t going to extricate itself from societal signals. Earnest dispatches from the likes of 90210 may suggest a minor, if not exactly emphatic, backlash against surgery as we’ve conceived it in the past, but they can’t compete with the sexy media spectacle of safe and groovy space-age technology and a wrinkle-free future. So in spite of a queasy feeling and a temptation to dismiss the whole idea of cosmetic surgery as an anti-woman plot and anyone who “chooses” it as a sucker, we must admit that in a complicated time, our thinking has to evolve, even if our calves, chests, and cheekbones don’t.

Andi Zeisler is saving up for a few extra limbs.

“Size 6: Is It Worth the Agony?” Marie Claire

the deal: Four size-6 women talk about how they got that way. “Cosmetic surgery convert” Livia Feigen, age 43, describes how liposuction on her inner and outer thighs, hips, and knees changed her bad body image, allowed her to dress better, and gave her more incentive to exercise. choice quote: “I told the doctor I wanted my sex appeal back. He assured me I would be pleased with the results.” pro, con, or on the fence? Hard to say, since Marie Claire takes a strictly hands-o? approach to this kind of “real women, real stories” feature. There’s no explicit editorializing; however, certain things do stand out as subtextual commentaryâ€šfor instance, the fact that while Feigen herself ends her testimony with the unambiguous comment, “It was the best thing I ever did,” the pull quote that runs beside her picture reads, “I still have 26 holes in my body from the liposuction.” The photos that accompany the four women’s stories also say a lot: the “au naturel” size 6, for instance, is the only one who’s shown eating. Feigen is pictured trying on shoes and primping in front of a mirror, underscoring the stereotype of cosmetic surgery as the playground of vain women with an unconscionable amount of footwear. gross-out factor: Low. “They vacuumed out so much fat that the doctor needed to get another bucket” may be more than you’d like to know, but Feigen’s account renders the actual procedure a lot less crucial than the postsurgery bliss. cosmetic surgery is: A wonderful way to take years o? your appearance, an esteem-booster par excellence, and a kick-start for further self-improvement.

“I Got Liposuction” Jump

the deal: Pseudonymous college student Claire o?ers a first-person account of the liposuction she got after years of hating her thighs and belly. The account details the whole a?air, from the preliminary consultation to the follow-up doctor visits, and it’s not a happy story. Despite what appear to be realistic expectations, after the grueling surgery, Claire’s postvacuum bod is not what she thought it would be, and she’s pissed. choice quote: “Even though some of the stu? I read about plastic surgery was really kind of gross and scary, the photos of ‘results’ dazzled me. I began to believe that if I could ever afford it, all of my problems would be solved.” pro, con, or on the fence? Again, hard to say, as this is ostensibly one woman’s account, with no editorializing. By the end of the saga she’s avowedly anti-lipo, yet she still consents, at a doctor’s urging, to undergo what is euphemistically called a “corrective contouring”â€šalso known as another session with the suction tubes. gross-out factor: Oy. Long passages detail the postprocedure scars, bruises, and body-girdle-wearing general agony that awaits the liposuction patient. “My pelvic area was completely black,” says Claire, and it’s plain she’s not talking about skin tone or an excess of pubic hair. cosmetic surgery is: Something that should be considered very carefullyâ€šnot a concrete solution, and certainly not a cure for a less-than-great body image.

“The Unkindest Cut” Living Fit

the deal: The magazine conducted a nationwide survey of 400 men and women aged 35-65, and the results are employed to address/ debunk certain “myths” about our society and its attitude toward cosmetic surgery. choice quote (from a psychologist): “As you age, your focus switches to the functionality of the body, rather than its appearance. You realize you want to be well and live a long time, and you forget about the wrinkles.” pro, con, or on the fence? Con, as evidenced in their reiteration that the American Society of Plastic and Reconstructive Surgeons’ statistics are often bloated, that baby boomers are really more comfortable in their bodies than younger surgery-seekers, and that “lite” cosmetic procedures like dermabrasion and Botox injections don’t really count as surgery. gross-out factor: The Pollyanna body-love tone of the story is somewhat nauseating in its phoniness, but other than that, no. cosmetic surgery is: An attractive story, but one that’s overhyped in the media. Pass the Botox!

“Breast Obsessed”

Harper’s Bazaar the deal: Big breasts vs. small breasts: a short history of the face-o?, and how cosmetic surgery has leveled the physical, if not the psychological, playing field. choice quote: “Surgery takes away part of who you are, and you have to bear other women’s judgments about what you’ve done.” pro, con, or on the fence? Straddling, but leaning discernibly toward con. Stressing that small breasts are associated with class and intelligence, and big ones with sex and stupidity, the author admits to fantasizing about a reduction, for both aesthetic and medical reasons. Several of her interviewees with implants admit that surgery only shifted the focus of their breast insecurity. Where many articles on cosmetic surgery talk vaguely about “doing it for myself” when self-esteem is the issue, “Breast Obsessed” takes on the slippery subject of how women relate to each other when it comes to what they’ve got on top. gross-out factor: Not so much, given that “Breast Obsessed” focuses exclusively on the psychological side of breast-related body image and surgery. cosmetic surgery is: Something that many women feel forced into due to certain long-held beliefs about what makes a woman attractive and desirable.

“Got Silicone?

Jenny Jones Doesn’t” Alternative Medicine the deal: An account of talk-show host Jenny Jones’s harrowing ten-year, five-surgery implant safari and her ultimate decision to oust them from her scarred, numb chest. choice quote: “In response to Jenny’s [pretaping] question of how he felt about implants today, [a doctor who was a Jenny Jones guest] answered, ‘I wouldn’t put one in with a gun held to my head.’ But when he got on camera, his resolve melted and when he was asked the same question, he replied, ‘I think they’re fine.’” bonus! choice irony: Jones’s comment that “I’m a self-help kind of person.” pro, con, or on the fence? Con to the max. The article focuses in particular on the e?ects of silicone poisoning, and on the fact that doctors often keep their patients’ pretty little heads free of info about the dangers of implants. gross-out factor: The description of Jones’s capsulotomy (a procedure where hardening of the breasts is “fixed” by having a surgeon manually squeeze the breasts to break the capsule) will have you clutching your own chest protectively. cosmetic surgery is: In Jones’s own words, “the biggest mistake of my life.”

“Lifts For Less”

American Health the deal: An article on the growing number of women who, anxious for the scalpel but balking at the clams, choose to have “discount” surgery, which involves being lifted/sucked/reshaped by a resident or as part of a medical or educational study. choice quote (from a plastic surgeon): “Surgery is a hands-on skill. You can only learn so much by watching other people operate or practicing new technologies on cadavers, steaks, or tomatoes.” pro, con, or on the fence? Pro, with warnings reserved not for the surgery concept itself, but for the perils that occasionally await the bargain shopper. gross-out factor: The author has a vague air of being ready to lose her lunch at the mere mention of cow collagen. cosmetic surgery is: Not something you want to cut corners on, unless you’re extremely gutsy or, at the very least, don’t mind having one side of your face higher than the other.

“Makeovers”

Hollywood Style” Celebrity Diet and Exercise the deal: We all know that Hollywood stars have the surgeon on speed dial, but let’s find out who they’re using and what they’re getting done, shall we? “Before” and “after” photos of Jane Fonda, Roseanne, and saline poster girl Pamela Anderson Lee testify. choice quote: “Board-certified plastic and reconstructive surgeon [Richard] Ellenbogen advocates taking years o? your face. ‘Your eyes are one of the first features people notice. Unfortunately, they’re also one of the first to show signs of aging. So why not give a lift to your lidsâ€šand yourself?’” pro, con, or on the fence? Pro, since the angle here is that actresses need their collagen and saline the way us common folk need beer and television. gross-out factor: See “choice quote.” cosmetic surgery is: Like breathing to Hollywood denizens, and wouldn’t we all like to be so lucky?